Comparative study on the efficacies of preoperative internal and external biliary drainage in pancreatic head cancer with distal biliary obstruction
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 3, Pages: 213-217(2026)
- 作者机构：
陆军军医大学第一附属医院肝胆外科，重庆 400038
- 作者简介：
- 基金信息：
DOI：10.11659/jjssx.02E025125
CLC： R657.4+3Received：25 February 2025，
Published：25 March 2026
- 稿件说明：
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汪慧,刘嘉龙,曹永.胰头癌远端胆道梗阻术前内外引流疗效的对比研究[J].局解手术学杂志,2026,35(03):213-217.
WANG Hui,LIU Jia-long,CAO Yong.Comparative study on the efficacies of preoperative internal and external biliary drainage in pancreatic head cancer with distal biliary obstruction[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):213-217.
汪慧,刘嘉龙,曹永.胰头癌远端胆道梗阻术前内外引流疗效的对比研究[J].局解手术学杂志,2026,35(03):213-217. DOI： 10.11659/jjssx.02E025125.
WANG Hui,LIU Jia-long,CAO Yong.Comparative study on the efficacies of preoperative internal and external biliary drainage in pancreatic head cancer with distal biliary obstruction[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):213-217. DOI： 10.11659/jjssx.02E025125.
摘要
目的
2
分析胰头癌合并远端胆道梗阻患者行胰十二指肠术前实施内外引流对围术期诊疗效率和远期肿瘤学结果的影响。
方法
2
回顾性分析本中心99例胰头癌合并远端胆道梗阻行胰十二指肠切除术患者的临床资料。其中52例接受内镜逆行胆道支架引流术（ERBD）的患者纳入内引流组，47例接受经内镜鼻胆管引流术（ENBD）或经皮肝穿刺胆道引流术（PTCD）的患者纳入外引流组。比较2组患者围术期指标、并发症、引流效率及远期肿瘤学结果。
结果
2
内引流组患者术后开始进食时间早于外引流组，术后抗生素使用时间长于外引流组，内镜下乳头括约肌切开术（EST）实施率高于外引流组，差异均有统计学意义（
P
<
0.05）。内引流组患者胆管炎、腹腔感染、术后胰瘘及术后胰腺出血发生率均显著高于外引流组（
P
<
0.05）。引流后5、7 d，内引流组患者总胆红素（TBIL）均显著高于外引流组（
P
<
0.05）；引流后3、5 d，内引流组患者谷丙转氨酶（ALT）水平显著高于外引流组（
P
<
0.05）。内引流组患者术后3年生存率、无瘤生存率均低于外引流组，差异有统计学意义（
P
<
0.05）。
结论
2
对于胰头癌合并远端胆道梗阻的患者，外引流在围术期准备、术后恢复、减少术后并发症及改善远期生存结局方面均较内引流具备显著的优势。
Abstract
Objective
2
To analyze the effects of preoperative internal and external biliary drainage on the perioperative diagnosis and treatment efficiency and long-term oncological outcome in patients with pancreatic head cancer complicated with distal biliary obstruction who underwent pancreaticoduodenectomy.
Methods
2
A retrospective analysis was conducted on the clinical data of 99 patients with pancreatic head cancer complicated with distal biliary obstruction who underwent pancreaticoduodenectomy at our center. Among them，52 patients who received endoscopic retrograde biliary drainage （ERBD） were enrolled in the internal drainage group， and 47 patients who underwent endoscopic nasobiliary drainage （ENBD） or percutaneous transhepatic cholangial drainage （PTCD） were assigned to the external drainage group. Perioperative indicators， complications， drainage efficiency and long-term oncological outcomes were compared between the two groups.
Results
2
In the internal drainage group， the time to initial postoperative oral intake was earlier， the duration of postoperative antibiotic use was longer， and the implementation rate of endoscopic sphincterotomy （EST） was higher than those in the external drainage group，with statistically significant differences （
P
<
0.05）.The incidences of cholangitis，abdominal infection，postoperative pancreatic fistula， and postoperative pancreatic bleeding in the internal drainage group were significantly higher than those in the external drainage group （
P
<
0.05）. At 5 and 7 days after drainage， the total bilirubin （TBIL） levels in the internal drainage group were significantly higher than those in the external drainage group （
P
<
0.05）. At 3 and 5 days after drainage， the alanine aminotransferase （ALT） levels in the internal drainage group were significantly higher than those in the external drainage group （
P
<
0.05）. The 3-year postoperative overall survival rate and disease-free survival rate in the internal drainage group were lower than those in the external drainage group， with statistically significant differences （
P
<
0.05）.
Conclusion
2
For patients with pancreatic head cancer complicated with distal biliary obstruction， external biliary drainage exhibits significantly superior advantages over internal biliary drainage in terms of perioperative preparation，postoperative recovery， reduction of postoperative complications， as well as improvement of long-term survival outcomes.
关键词
Keywords
references
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